[6.3.4.3.] Active and Passive: Morally Equivalent?

 

In another article, Rachels famously argued that active euthanasia is morally equivalent to passive euthanasia. In other words, he argued that if active euthanasia is immoral, then so is passive euthanasia; and if passive euthanasia is morally permissible, then so is active euthanasia. 

 

On Rachels’ view, there is no more moral difference between killing someone and accidentally letting him die when you could easily save him, e.g. no moral difference between deliberately causing someone to drown (e.g., by holding his head under the water) and neglecting to save someone from drowning when you could easily save his life:

 

                … Smith stands to gain a large inheritance if anything should happen to his six-year-old cousin. One evening while the child is taking his bath, Smith sneaks into the bathroom and drowns the child, and then arranges things so that it will look like an accident.

… Jones also stands to gain if anything should happen to his six-year-old cousin. Like Smith, Jones sneaks in planning to drown the child in his bath. However, just as he enters the bathroom, Jones sees the child slip and hit his head, and fall face down in the water. Jones is delighted; he stands by, ready to push the child’s head back under if it is necessary, but it is not necessary. With only a little thrashing about, the child drowns all by himself, “accidentally,” as Jones watches and does nothing.[1]

 

Rachels maintains that the action of Smith and the inaction of Jones are equally bad—Smith is no worse than Jones—both are horrible to the same degree.

 

According to Rachels, rather than focusing on whether a death is caused or allowed in determining whether a case of euthanasia is morally permissible, we should focus on motives and consequences.

 

In general, if the motives are the same, and the consequences are the same, then the actions (or failures to act) are morally equivalent.

 

In the Smith and Jones thought experiment, the two men’s motives are the same (they both want the boy to die so that they will inherit a lot of money), and the consequences are the same (the boy dies in each case). This explains why Smith and Jones are both equally bad, even though Jones does not actively bring about the death of his cousin.

 

Rachels applies the same reasoning to the case of euthanasia. If the motives are the same (what is desired is that the patient’s suffering end), and the consequences are the same (the patient dies), then there is no moral difference between active and passive. The fact that in active euthanasia, someone actively intervenes so as to bring about the death of the patient, makes no moral difference. It is morally the same as passive euthanasia.

 

 

[6.3.5.] Against Assisted Suicide: Richard Doerflinger.

 

Richard Doerflinger is Deputy Director of the Secretariat for Pro-Life Activities, United States Conference of Catholic Bishops.[2]

 

In the first article we read about euthanasia, Rachels was arguing in favor of active euthanasia.

 

In this second article, “Assisted Suicide: Pro-Choice or Anti-Life?”, Doerflinger is arguing against “physician-assisted suicide,” by which he means both physician-assisted suicide and physician-assisted dying.

 

 

[6.3.5.1.] Secular vs. Religious Views of Assisted Suicide.

 

As we have seen, according to utilitarianism, euthanasia (including physician assisted suicide and dying) are sometimes morally permissible: it is moral in those cases in which it increases the happiness / welfare / well-being and decreases the suffering of the beings who are affected by it. It should be no surprise that utilitarianism leads to this conclusion, since it promotes quality of life as the most important moral value.

 

Euthanasia is one issue (there are others) about which utilitarianism disagrees with traditional Christian morality, which emphasizes the sanctity of life. According to this view, active euthanasia and assisted suicide and dying are never morally permissible. Life is a gift from God, who created humanity in his image. So it is always immoral for a human being to end the life of another, even to put that person out of his or her suffering. As Doerflinger says:

 

The intrinsic wrongness of killing the innocent, even with the victim’s consent, is all but axiomatic in the Jewish and Christian worldviews that have shaped the laws and mores of Western civilization and the self-concept of its medical practitioners. This norm grew out of the conviction that human life is sacred because it is created in the image and likeness of God, and called to fulfillment in love of God and neighbor. (RTD 311-12)

 

Doerflinger recognizes that society has become increasingly secular (non-religious), and he wants to argue against assisted suicide and dying on secular grounds. [This is somewhat similar to Don Marquis’s desire to argue against abortion on completely secular grounds.]

 

 

[6.3.5.2.] Against the Argument from Autonomy.

 

Doerflinger considers a pro-AS (assisted suicide) argument that goes something like this [this is my formulation of the argument suggested by Doerflinger]:

 

The Argument from Autonomy

1.      Autonomy (an individual’s freedom to make decisions, especially important life-decisions, for herself) is of supreme moral importance and should always be respected.

2.      Denying a person the right to assisted suicide would disrespect her autonomy.

3.      Therefore, a person should not be denied the right to assisted suicide.

 

Doerflinger criticizes this argument as follows:

·         “Life, a human being’s very earthly existence, is the most fundamental right because it is the necessary condition for all other worldly goods including freedom” (RTD 313) [This seems to imply that the first premise is false.]

·         “suicide is not the ultimate exercise of freedom but its ultimate self-contradiction: A free act that by destroying life, destroys all the individual’s future earthly freedom. ... Sometimes one must limit particular choices to safeguard freedom itself, as when American society chose over a century ago to prevent people from selling themselves into slavery even of their own volition.” (RTD 313-14)

·         So denying someone the right to AS does not disrespect her autonomy, and allowing AS does not respect her autonomy. Rather, allowing AS in order to protect autonomy is contradictory: it is like saying: “I will respect your freedom by helping you destroy a necessary condition of that freedom.” [And this definitely implies that the second premise is false.]

 

Doerflinger considers the following defense of the Argument from Autonomy:

·         “assistance in suicide is only being offered to those who can no longer meaningfully exercise other freedoms due to increased suffering and reduced capabilities and lifespan.” (RTD 314)

 

He replies: “even these hardships do not constitute a total loss of freedom of choice.” (RTD 314, emphasis added) Patients who are capable of choosing suicide are also capable of making lots of other important choices, e.g., “choices regarding the assessment of his or her past life and the resolution of relationships with family and friends. He or she must finally choose at this time what stance to take regarding the eternal questions about God, personal responsibility, and the prospects of a destiny after death.” (RTD 314)

 

 

Stopping point for Monday October 5. For next time, finish reading the Doerflinger article (RTD ch.35, pp.315-20); study today’s notes; as always, a pop quiz is possible.